# LIGHT AND MIND WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Light And Mind WELLNESS LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609449677
- **Authorized official:** AISHA HASSAN-DAVIS CNS,PMH-NP, APRN (OWNER/PROVIDER)
- **Authorized official phone:** (443) 239-2033

## Contact information

- **Practice address:** 8707 COMMERCE DR STE E, EASTON, MD 21601-6910
- **Practice address phone:** (410) 855-4664
- **Practice address fax:** (855) 461-3481
- **Mailing address:** 8707 COMMERCE DR STE E, EASTON, MD 21601-6910
- **Mailing address phone:** (443) 239-2033
- **Mailing address fax:** (855) 461-3481

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/19/2021
- **Last updated:** 01/25/2025